Risk Adjustment Software Built for Accurate HCC & RAF Scoring
Improve documentation accuracy, reduce revenue leakage, and strengthen compliance with intelligent risk-adjustment automation built for modern healthcare teams.
Trusted by the best in the industry
A Revenue-Safe Approach to Risk Adjustment Accuracy
Stay Compliant With Evolving CMS & Payer Requirements
- Daily Smart Edits align documentation and coding to current regulatory standards.
- Detect missing, outdated, or unsupported clinical documentation before submission.
- Strengthen audit readiness with proactive compliance monitoring.
Improve Coding Precision & Capture Every Eligible HCC
- AI scans documentation to identify missed or under-specified conditions.
- Ensures ICD-10, HCC, and RAF coding accuracy supported with proper clinical evidence.
- Prevents avoidable denials and revenue leakage.
Increase Workflow Efficiency & Transparency
- Automatically surface care-gap alerts and HCC opportunities during review.
- Rapid Agents (LLM + ML) continuously learn from payer responses and historical patterns.
- Full audit trails include rationale for every coding decision.
AI-Powered Risk Adjustment Suite
Real-Time HCC Detection & Documentation Review
Strengthen risk-adjustment accuracy with automated chart intelligence.
- Detect missed or unsupported HCCs before chart completion.
- Automated validation of clinical evidence and supporting documentation.
- Instant alerts when payer rules or CMS guidelines change.
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Autonomous Coding & RAF Optimization
Accelerate workflows while improving accuracy.
- 96%+ accurate autonomous HCC coding
- Inline RAF scoring and care-gap detection to prevent under-coding
- Line-level AI reasoning for full audit visibility
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Audit Prevention & Automated Appeals
Protect revenue before and after submission.
- AI Smart-Edit engine prevents unsupported or risky submissions
- Real-time risk scoring flags potential audit triggers
- Auto-generate appeals with evidence-backed justification
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What Sets Us Apart
Accelerated Implementation
- Go live in as little as 30 days with rapid EHR integration and automated data ingestion.
- Process thousands of encounters per minute with 96%+ accuracy using RapidCode.
- Reduce manual workload and improve coding turnaround with streamlined workflows.
Maximized Risk Capture
- Identify missed or misclassified HCCs before submission with RapidCDI and RapidCode.
- Improve RAF scoring and ensure all risk factors are accurately represented.
- Capture every compliant reimbursement opportunity while reducing audit exposure.
Continuous Compliance & Learning
- Receive real-time CMS and payer updates, including new model versions and coding standards.
- Utilize weekly AI retraining on payer feedback to continuously improve accuracy.
- Maintain AHIMA/CMS-compliant audit trails and complete coding transparency.
Results You Can Trust
RapidClaims delivered what other vendors only promised. We've seen a 30% reduction in AR days within one quarter, unlocking $2.5M in accelerated cash flow. Their platform adapts to our specific workflows instead of forcing us to change our processes.
CFO, Major Health System
$2.5M
Accelerated cash flow
30%
Reduction in AR days
"With RapidClaims, we're maximizing our limited resources while improving revenue capture by 5%. Our team now spends more time on patient care and less on administrative tasks."
Director HIM, Federally Qualified Health Center
5%
↑ increased revenue
40%
Reduction in coding and billing costs
RapidRisk transformed our value-based care documentation, improving RAF by 15% and reducing documentation gaps by 22%. This directly impacts our shared savings and quality metrics.
Medical Director, Leading Accountable Care Organization
15%
↑ RAF
45%
New conditions identified
Our clean claim rate jumped from 92% to 99% with a 96% first pass yield rate. With RapidClaims, we improved the productivity of our coding staff by 100%. Our team only focuses on complex cases that require human expertise.
VP Revenue Cycle, Multi-Specialty Physician Group
27%
Reduction in claim denials
70%
Reduction in cost to collect
Take Control of Risk, Accuracy, and Reimbursement Integrity Now
RapidClaims AI modules, RapidCode, RapidCDI, RapidScrub, and RapidRecovery, work together to enhance coding accuracy, ensure compliant HCC capture, and maximize reimbursement performance across all risk-adjusted programs.
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Frequently Asked Questions
Transform Your Revenue Cycle in 30 Days or Less
Join leading healthcare organizations already seeing results with RapidClaims.
